Mitra H Bridwell, R, MR
Individual provider Active NPI Magnetic Resonance Imaging Radiologic Technologist · Decatur, AL
NPI 1023247145 · NPPES record last updated Jul 10, 2009
Key facts
- NPI
- 1023247145
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Magnetic Resonance Imaging Radiologic Technologist 2471M1202X
- License
- 290989 (AL)
- Practice address
- 1201 13TH Ave SE
Decatur, AL 35601-4300 - Phone
- (256) 350-7779
- Fax
- (256) 350-2272
- NPI assigned
- Jul 10, 2009
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 290989 | AL | MD | Magnetic Resonance Imaging Radiologic Technologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Open MRI of Decatur LLC | Past | Accepting new patients | |
| Radiology of Hunstville PC | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Magnetic Resonance Imaging Radiologic Technologist | 2471M1202X | 290989 | AL | Yes |
Addresses
Primary practice location
1201 13TH Ave SE
Decatur, AL 35601-4300
Mailing address
107 Marysa Dr
Huntsville, AL 35811-8770
Phone (256) 683-2171
Other providers in Decatur, AL
- Nicholas Tilford Braswell IV
- Ashley Brenner
- Michelle Brewer
- Brian R James MD PC
- Shequita Madry Bridgeforth
- Yvonne Briggs
- Leah Bromley
- Kellie Kilpatrick Brooks
- Sarah Brooks
- Catherine Brown
All providers in Decatur, AL · Magnetic Resonance Imaging Radiologic Technologist in Alabama
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 10, 2009. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.